5 months Post-Op - Crease in Nipples

[90293]

Hi Doctors:

I had surgery about 5 months ago and my left nipple still has a noticable crease in it. I feel what appears to be scar tissue below the incision (it almost feel like a cyst). I went to see my Doctors today and he basically said there is nothing that can be done and that with time the scaring should continue to soften and get better, but he admitted that he doesnt think it will be perfect. I asked what about Kenalog or a revision and he didn't seem to be keen on either. Can something like this be rectified with Kenalog and/or a revision?

The other issues with the surgery that I can live with are that when I raise my arms the aerola area indents slight inwards which again he said cannot be solved. He said that if he were to make it look normal when I raise my arms it would look weird when relaxed. Also, the right nipple has another scar line accross the middle of the nipple (which he claims is not an incision, but something that happens with the sutures or something bullcrap like that...which is actually worse looking that the scar itself.

Thank you for the feedback.

[DrBermant]

Hi Doctors:

I had surgery about 5 months ago and my left nipple still has a noticable crease in it. I feel what appears to be scar tissue below the incision (it almost feel like a cyst). I went to see my Doctors today and he basically said there is nothing that can be done and that with time the scaring should continue to soften and get better, but he admitted that he doesnt think it will be perfect. I asked what about Kenalog or a revision and he didn't seem to be keen on either. Can something like this be rectified with Kenalog and/or a revision?

The other issues with the surgery that I can live with are that when I raise my arms the aerola area indents slight inwards which again he said cannot be solved. He said that if he were to make it look normal when I raise my arms it would look weird when relaxed. Also, the right nipple has another scar line accross the middle of the nipple (which he claims is not an incision, but something that happens with the sutures or something bullcrap like that...which is actually worse looking that the scar itself.

Thank you for the feedback.

The male chest should look good in animation, not just with the arms down. It can be quite difficult to enjoy playing sports with a shirt off showing deformity while enjoying life. Just seeing a doctor's results with arms down or not flexing muscles only tells part of the story of the result in technique.

Standard After Gynecomastia Surgery Pictures or even better yet, Standard Video to Demonstrate Male Chest Contour Issues can show others your concerns. 

All surgery results in scars. Revision surgery only replaces scars with new scars. The trick is the nature of the scars and how well they can be hidden.

Folds of extra tissue can be a factor after deflation / removing excess. Sometimes this is just an issue of adhesion. At other times there is a compromise of leaving the fold or dealing the with the compromise of a skin reduction scar.

A depression lifting the arms can be one form of a subtle crater deformity as demonstrated in this example of a Bursa Crater Deformity. Check out the still pictures in the "Revision Gynecomastia Muscle Moving Pictures" or the Revision Gynecomastia Before and After Surgery Videos. In this case I was able to repair that patient's crater.

Sometimes there are indeed limitations as to what surgery can offer. At other times revision can improve the contour.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[Dr. Elliot Jacobs]

It would be useful if you could post some photos (preferably taken by another person).  Full chest and then closeups of the nipples -- both in relaxed position (arms at sides), muscles tensed and then arms raised over the head.

It sounds as if you might need a revision since your own surgeon in essence has thrown up his hands.  Would suggest you consult an experienced gyne surgeon -- there are many such surgeons around the country -- just do your homework.

Don't give up hope -- oftentimes substantial improvement can be achieved with appropriate revision treatment.

Dr Jacobs